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Pathway / mechanism context Successful wound healing depends on fibroblasts (which regulate the production of extracellular matrix) and immune system cells

Common neurological manifestations include: Paraesthesia (pins and needles) in the hands and feet Numbness and altered sensation Difficulty with balance and coordination (ataxia) Memory problems and cognitive impairment Mood changes, including depression and irritability In severe cases, visual disturbances and confusion These neurological features arise from demyelination of peripheral nerves and the spinal cord, a condition known as subacute combined degeneration when it affects the posterior and lateral columns of the spinal cord

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Urate-lowering treatment improves long-term health outcomes Unlike many other chronic conditions, gout can usually be successfully managed with pharmacological treatment, education and regular follow up

Strict vegans and vegetarians are also at higher risk for deficiency since B12 occurs naturally only in animal-derived foods

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